02/15/2018

Experiencing shooting pain from your back to your feet? You’re not alone.

Minimally-invasive treatment option available for lower back, leg pain

As much as 80 percent of the population will experience back pain at some point in their lives. Sometimes the pain is contained to a certain section of the back. But sometimes people experience pain radiating from their lower back through the back of the thigh and down the leg possibly even to the foot or toes.

The lower back, or lumbar area, is made up of five individual bones located below the rib attachment of the thoracic spine but above the sacrum and pelvic bone, describes Dr. Davis Reames, neurosurgeon at Neurological & Spine Institute. The lumbar area allows for substantial spinal motion, especially forward flexion. It is also a common source of back pain.

One possible result of lower back pain is lumbar radiculopathy, or leg pain due to pinched nerves in the spine. When discs in the spine became damaged, they can affect nerve roots nearby, leading to radiculopathy.

Lumbar radiculopathy is leg pain distinct in nature, Dr. Reames says. Symptoms of lumbar radiculopathy include:

  • Weakness
  • Numbness
  • Pins and needles sensation
  • Sharp pain with sitting or coughing

“There are also important associated signs you may not as easily notice that your doctor will check for such as reflex changes and gait abnormalities, which can be subtle,” says Dr. Reames.

What causes lumbar radiculopathy?

Common causes of nerve impingement originating in the lower back include bone spurs, also known as osteophytes, resulting from chronic remodeling of bone due to a variety of stresses, Dr. Reames says. Causes of these bone spurs are generally inherited, occupational, traumatic or inflammatory.

Disc disorders, such as disc herniations, broad disc bulges or chronic calcified discs, also can result in leg pain. Less common causes of radiculopathy are tumors, cysts or metabolic or inflammatory conditions such as diabetes or cancer.

“Leg pain can be severely disabling and often stop us completely in our tracks affecting our jobs, our family and negatively impacting our quality of life,” Dr. Reames says.

Dr. Davis Reames
Dr. Davis Reames, neurosurgeon at Neurological & Spine Institute

Fortunately, there are effective treatment options. Radiculopathy is typically treatable without surgery. Medications (such as ibuprofen), physical therapy, injections and some degree of lifestyle modifications can be used to treat the pain, Dr. Reames says.

Related article: The dos and don’ts when dealing with back pain

If your pain worsens, you start to lose feeling in the affected leg, you develop problems with bowels or bladder or pain returns after successful treatment, you should contact your doctor or specialist. Depending on the exact cause of your condition, minimally-invasive treatment options are available.

“When the pain limits your quality of life to a point you can no longer enjoy or perform your activities of daily living or other concerning signs have developed, such as any degree of weakness, numbness or difficulty with gait, you should notify your doctor,” Dr. Reames says. “It is important to see a specialist who will first perform a detailed history to understand how your condition is negatively impacting your quality of life. That’s followed by a focused but thorough exam to best uncover the severity of nerve damage and careful review of images with respect to your specific complaints in order to determine treatment options.”

Minimally-Invasive Decompression

Dr. Reames discusses with his patients a wide variety of treatment options to best provide patients with relief in the least invasive way, with the goal to avoid spinal surgery. Dr. Reames prefers a minimally-invasive decompression procedure.

During the procedure, a small tube is placed under sequential dilation which temporarily splits the longitudinal muscle fibers rather than disconnecting them from their attachment at the bone. The tube is placed through a small 18mm incision under the guidance of imaging. This allows a microscope to assist in carefully removing disc herniations, cysts, bone spurs or other nerve impingement resulting in improvement in the patient’s pain and disability. 

Dermabond glue is then placed on the skin and patients are sent home the same day with a decreased rate of infection, less blood loss and quicker recovery, Dr. Reames says. Some patients may experience immediate improvement in leg pain.

Prevention

It’s not always possible to prevent lower back and leg pain, but the following can play a key role in protecting your back:

  • Regular exercise
  • Maintaining proper posture
  • Use good body mechanics, such as lifting properly and avoid standing for long periods of time

For more information about Dr. Reames and the Neurological & Spine Institute, visit their website.

  • St. Joseph's Hospital Campus: 11705 Mercy Blvd., Savannah, GA 31419, (p) 912-819-4100
  • Candler Hospital Campus: 5353 Reynolds St., Savannah, GA 31405, (p) 912-819-6000
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St.Joseph's Hospital Campus: 912-819-4100

Candler Hospital Campus: 912-819-6000